Spencer’s Benefits Reports NetNews – June 26, 2015

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Spencer’s Benefits Reports is taking a brief break. Spencer’s news and reports will not be issued June 29 through July 3. Publication will resume on July 6, 2015. Happy Independence Day to all of our subscribers…

The American Institute of CPAs (AICPA) has written to top tax lawmakers in Congress urging them to enact legislation to exempt certain types of health reimbursement arrangements (HRAs) from group health insurance requirements so that employers can offer health insurance coverage to more employees. An HRA is an employer-funded arrangement that reimburses an employee for medical care expenses, including premiums for health coverage, and the reimbursements can be made on behalf of the employee’s spouse and dependents. HRAs fall under the rubric of employer payment plans, which are formal or informal arrangements under which the sole benefit to the employee is direct payment or reimbursement by the employer of the employee’s premiums for health coverage…

In 2015, 29 percent of all employer-sponsored health plans are high-deductible health plans (HDHPs), according to recent research from HighRoads. The2015 Medical Trends and Observations report noted that this is up from 22 percent in 2014—a 32 percent increase…

Finding issues of fact on whether an FMLA certification form indicated an employee’s knee injury was a serious health condition; whether the employee gave proper notice of the need for leave, considering it was unforeseeable; and whether the employer granted her an extension for providing certification, when a vice president told her to provide it “as soon as possible,” the Eleventh Circuit U.S. Court of Appeals reversed summary judgment on her FMLA interference claim. The fact that her doctor estimated she would be incapacitated for 13 weeks did not disqualify her from reinstatement—that was only an estimate and was contradicted by evidence that she could have returned within the protected 12-week-period. Her retaliation claim was also revived…

A report summarizing the budgetary and economic effects of a repeal of the Patient Protection and Affordable Care Act (ACA) was issued by the Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT). The report explains that a repeal of the ACA would increase federal budget deficits by $137 billion over the next 10 years…

Although the vast majority of employers (88 percent) still rely on traditional plan designs (co-pays and coinsurance), many are ready to focus on new and novel approaches to managing specialty drugs costs. That’s according to the Midwest Business Group on Health’s (MBGH) fourth annual employer survey on specialty drug management…

Of employers that offered a flexible spending account (FSA) to employees, 89 percent have implemented the newly-allowed carryover option, and of these employers, 73 percent said participation in the FSA increased, according to recent research from the Employers Council on Flexible Compensation (ECFC)…

One-third of employees would quit if employer failed to sponsor health benefits

Employers who fail to fully sponsor their employees’ health benefits would face widespread employee dissatisfaction, lower employee productivity and the loss of nearly a third of their employees within one year, according to recent research by Accenture…

The Department of Labor’s Women’s Bureau is going to administer $1.25 million for research and analysis on how paid leave programs can be developed and implemented across the country. This latest funding opportunity from the DOL builds upon a 2014 Women’s Bureau grant program that awarded a total of $500,000 to support paid leave feasibility studies in three states and the District of Columbia…

After the Patient Protection and Affordable Care Act (ACA) was passed into law, there was some speculation that small firms might start self-insuring to avoid some of the costs of complying with the law. However, recent research from the Employee Benefit Research Institute (EBRI) has found that so far (up to 2013, the latest data available), there is no evidence that they are doing so. Although the instance of self-insured plans is growing, it is not among small employers…

Subsidy recipients unaware of pending case that could cause aid to disappear

Although the King v. Burwell case currently before the Supreme Court is receiving lots of news coverage, perhaps not everyone is paying attention. According to a survey of eHealth customers, only 7 percent of survey respondents receiving subsidies to help them pay for their major medical health insurance were aware of the case…

Pennsylvania’s contingency plan for Supreme Court ruling includes creation of state exchange

A contingency plan involving a switch to a state-based Marketplace, from a federally-based one, is being put in place at the urging of Pennsylvania governor Tom Wolf, in an effort to keep 382,000 Pennsylvanians from losing health care premium subsidies, according to information released on the Pennsylvania Insurance Department website. Pennsylvania currently has a federally-run exchange, and, if the U.S. Supreme Court rules inKing v. Burwell that premium subsidies are only available through state-run exchanges, Wolf is concerned that the cost of health insurance will make health care out of reach for citizens of his state…